A brief review of the VI-RADS classification for bladder tumors on MRI (and a call for increased interface, consistent communication and more joined studies by the radiological and urological communities).
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1993年,美国放射学会(American College of Radiology, ACR)提出了一种新的乳腺肿瘤评估和报告分类,称为BI-RADS (breast Imaging reporting and Data System,乳腺成像报告和数据系统),这是一种标准化的词汇,它是在已建立的5级ACR系统(Likert量表)的基础上发展起来的(1)。BI-RADS的目的是提高良恶性疾病的区分,消除放射学报告中的歧义。允许对数据进行自动审计,并改善与转诊医生的临床界面。目前,有20多种RADS可用于许多疾病和器官的放射学评估,其中9种是在ACR标准和监督下开发的,其中两种使用范围更广,知名度更高:2018年,一个由放射科医生、泌尿科医生、病理学家和放射肿瘤学家组成的多学科小组开发并发布了一个名为VI-RADS(膀胱成像报告和数据系统)的新评分系统,重点关注膀胱癌在MRI上的局部分期。包括MRI方案的标准化和结构化报告系统的建议,以改善转诊医生和放射科医生之间的沟通(3)。该系统的主要目标是通过无创成像方法克服经尿道膀胱肿瘤切除术(turt)的风险和局限性,如膀胱穿孔和分期不足/过分期。该系统采用5分制(VI-RADS 1至VI-RADS 5),使用多参数MRI(包括高分辨率t2加权、弥漫性加权和动态对比增强成像),对先前检测到的病变中膀胱壁肌肉层浸润的风险进行分层。VI-RADS迅速被放射学和泌尿学社区所接受,此后发表了许多多中心研究,证实该系统具有良好的观察者间一致性和局部分期的准确性。这些研究包括Woo等人(4)和Luo等人(5)于2020年发表的两篇系统综述和荟萃分析,发现使用VI-RADS对膀胱癌局部分期的AUC准确性相似(在0.92和0.94之间)。另一篇系统综述和荟萃分析,由Del Giudice等人(6)于2022年发表,重点关注读者间可重复性,并发现Cohen 's Kappa为0.83。Nicola等人(7)的文章对VI-RADS的许多方面进行了非常全面和逐步的回顾,目标是泌尿外科社区。至关重要的是,泌尿科医生(以及临床肿瘤学家和放射肿瘤学家)熟悉这些应用,社论评论卷48(4):623-624,2022年7月8日
期刊介绍:
The Journal of Fish Biology is a leading international journal for scientists engaged in all aspects of fishes and fisheries research, both fresh water and marine. The journal publishes high-quality papers relevant to the central theme of fish biology and aims to bring together under one cover an overall picture of the research in progress and to provide international communication among researchers in many disciplines with a common interest in the biology of fish.